Because opiates seem to have behavioral and biochemical effects which involve interaction with catecholamine neurotransmitter systems, clinicians have tried to modify opiate euphoria and withdrawal by giving drugs which modify these neurotransmitters. This approach has not met with any great success, and the usual treatment for opiate withdrawal is replacement with methadone followed by a period of maintenance for psychosocial rehabilitation and then detoxification or gradual withdrawal. However, detoxification from methadone maintenance is a slow and difficult process, and the patients frequently experience minor abstinence symptoms. Opiate agonists will block withdrawal symptoms, but have their own potential for abuse and withdrawal symptoms. A non-opiate treatment which could control symptoms during acute opiate withdrawal would be welcome.
Studies in rodents and primates suggest that the neurotransmitter noradrenaline (norepinephrine) is involved in opiate withdrawal, and my early experience with clonidine supports a noradrenergic mediation of opiate withdrawal.